What to know about infant vomiting?

Some babies vomit at some point in time and in the majority of cases, this is not significant. Vomiting in newborn babies covers different types resulting from different causes.

Vomiting or more often, regurgitation (spitting up) is a comparatively frequent symptom seen in infancy. In the majority of cases, vomiting in newborn babies is not to worry about and rarely continues beyond the first few feeds.

Vomiting vs spitting up

First of all, it is important to know that there’s a difference between real vomiting and just spitting up. In vomiting, one forcefully throws out stomach contents through the mouth; while, in spitting up (usually seen in infants under one year of age) stomach contents easily flow out of the mouth, often with a burp.

Causes of vomiting

The common causes of spitting up or vomiting differ based on age. For instance, during the first few months, the majority of infants spit up small amounts of milk, usually within an hour of feeding. It will occur less commonly if a baby is burped frequently and if active play is limited right after meals. The frequency of spitting up usually decreases as the baby grows older, but may persist in a mild form until 10-12 months of age. This is not a serious condition and doesn’t interfere with normal weight gain. 

Occasional vomiting can be seen during the first month. If it occurs repeatedly or is unusually forceful, talk to the paediatrician. It could result from just a mild feeding difficulty, but it also could be a sign of something serious.

Persistent Vomiting

From 2 weeks to 4 months of age, persistent forceful vomiting may occur, which can be caused by a thickening of the muscle at the stomach exit, preventing food from passing into the intestines. This needs immediate medical attention. The important sign of this condition includes forceful vomiting occurring around 15-30 minutes or less after every feed. If you notice this, consult your paediatrician as soon as possible.

Gastroesophageal reflux disease

Sometimes, the spitting up in the first few months of life worsens instead of improving—that is, although it’s not forceful, it occurs all the time. This occurs when the muscles at the lower end of the oesophagus get overly relaxed and let the stomach contents back up. This condition is termed gastroesophageal reflux disease (GERD). This can usually be controlled by doing the following:

1. Avoid overfeeding or offer smaller feeds more frequently.
2. Burp the baby frequently.
3. Keep the baby in a safe, quiet, upright position for minimum of 30 minutes after feeding.

If these steps don’t help, your paediatrician may refer you to a gastrointestinal (GI) specialist.

Infection

After the first few months of life, stomach or intestinal infection is considered to be the most common cause of vomiting. Viruses are the most frequent infecting agents, but occasionally bacteria and even parasites may be the cause. The infection also may cause fever, diarrhoea, and sometimes nausea and abdominal pain. Rotaviruses are a primary cause of vomiting in infants and young children but are becoming less common compared to that in the past, due to the availability of a vaccine. 

Occasionally infections outside the gastrointestinal tract may also cause vomiting. These comprise infections of the respiratory system, infections of the urinary tract, otitis media, meningitis, and appendicitis. Some of these conditions need immediate medical attention, so look for the following trouble signs and consult your paediatrician if they occur. 

• Blood or bile (a green-coloured material) in the vomit
• Severe abdominal pain
• Exhausting, repeated vomiting
• Swollen or enlarged abdomen
• Tiredness or severe irritability
• Convulsions or fits
• Signs or symptoms of dehydration, such as dry mouth, absent tears, and decreased urination
• Inability to drink an adequate quantity of fluid
• Vomiting continuously over 24 hours